NEW YORK (Reuters Health) - Women who are carriers of
BRCA1/2 gene mutations that put them high risk for cancer may
opt to undergo mastectomy and ovary removal as a cancer
prevention strategy. Now, a small study suggests it's possible
to combine the two procedures into a single operation, without
undue complications.

On average, the combined procedure took 9.3 hours to
perform and patients were hospitalized for 5.4 days afterward,
according to the report in the online journal BMC Cancer.

Women with BRCA1 or BRCA2 mutations are known to be at
greatly increased risk of both breast and ovarian cancer, Dr.
Funda Meric-Bernstam and colleagues point out. By 70 years of
age, up to 85 percent of carriers will develop invasive breast
cancer and up to 65 percent will develop invasive ovarian
cancer, the team from the University of Texas M. D. Anderson
Cancer Center in Houston notes.

Women with these mutations may choose to be intensively
monitored for any sign of cancer, to take preventive measures
with tamoxifen treatment, or to undergo preemptive removal of
her breasts and ovaries. Although the last approach is more
aggressive, research has shown it to be highly effective in
preventing the associated cancers.

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Typically, the mastectomy is performed first and the ovary
surgery is performed months later during one of the breast
reconstruction procedures that most patients elect to undergo.

The new findings, which are based on a review of 12
patients treated at the authors' center, suggest that
mastectomy and ovary removal can be safely rolled into one
operation. The average patient age was 43 years and 10 of the
women had a prior breast cancer. Ten women also underwent
bilateral breast reconstruction during the combined procedure.

None of the patients experienced any major complications
during the operation. Afterward, however, there were three
instances of problems related to the surgery that needed
attention, and one case of pneumonia.

After an average of seven years, none of the patients
developed a new cancer, but two had a recurrence at other sites
in the body.

According to the authors, greater convenience for the
patient is a key advantage with the combined procedure.
Furthermore, doing both procedures at once reduces the
theoretical risk that ovarian cancer will arise between staged
procedures.